Perinatal deaths and major lethal and non-lethal congenital malformations occurring in this hospital from 1979-82 inclusive were related to the ethnic group of the 15 438 mothers. The highest crude perinatal mortality rates occurred in Indian and Pakistani populations (18-3 per 1000 and 24-1 per 1000 respectively). The highest incidence of congenital abnormality also occurred in these groups (13-3 per 1000 and 12*8 per 1000 respectively), but there was considerable variation in the distribution of different malformations.

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Summary An assessment of nutritional status using anthropometric and biochemical measurements was made during pregnancy in 8 European and 15 Asian women who produced babies which were light for gestational age. These results were compared with similar measurements in women of both races with normal or pathological pregnancies (hypertension or bleeding) who produced babies of normal size. European mothers of light for gestational age babies with one exception had pregnancies complicated by pathology. They were heavy and fat but apart from urinary peptide hydroxyproline (which was reduced), no other biochemical measurement was specifically associated with poor intrauterine growth. Asian mothers of light for gestational age babies mostly had pregnancies not complicated by obstetric pathology. They gained less weight and fat during the second trimester and during the third trimester, they had biochemical evidence of a poorer nutritional status. Some of the biochemical changes were also noted in pathological pregnancies even though the mothers gained weight and fat normally and had well grown babies.

A four-dose vaccination schedule was used to interrupt perinatal transmission of hepatitis B virus from carrier mothers to their babies. Of 49 babies immunised and successfully followed up, 43 (88%) became immune: 15 out of 21 (71%) of babies born to HBeAg + mothers became immune, the other 6 becoming the only carrier babies in the study. Without immunisation a carrier rate in excess of 70% would have been expected in this high-risk group. Vaccine alone, given in a rapid immunisation schedule, protected the majority of babies at risk. In those babies in whom the carrier state occurred in spite of immunisation, infection may have taken place in utero, or the infant may have failed to produce adequate antibody in response to the vaccine.

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